Understanding and Preventing Childhood Drug Use Risk

修订后的申请建议将早期步骤多站点项目（ES-M）延长五年，重点是了解和预防早期药物使用风险。ES- M项目是俄勒冈州大学（迪希恩）儿童和家庭中心、匹兹堡大学（肖）和弗吉尼亚大学（威尔逊）的合作项目。前五年在超过预期的招募率（731），保持高保留率（85%），让家庭参与我们的家庭干预模式，以及减少2至4岁儿童的问题行为和情绪困扰方面取得了相当成功。我们发现，改善儿童的适应调解改善家庭管理的做法。在接下来的五年里，我们建议调整家庭干预模式，为每个孩子的过渡到公立学校系统提供支持，并进行发展分析，以更好地了解早期出现的学校能力，早期越轨的同伴参与问题行为，情绪困扰，以及解决兄弟姐妹在发展中的作用，并作为干预结果变量。建议每半年进行一次强化评估，包括家访和直接观察，以及每年评估儿童的问题行为和家庭背景下的自我调节。这项评估建立在现有的多代理人和多方法的评估战略，包括每年的直接观察以及儿童和家庭特征的测量。我们建议，这项研究将测试一个可行的，具有成本效益的，以家庭为中心的干预措施，可以在WIC或类似的服务环境中启动，并继续在公立学校环境中保持的有效性。此外，数据集提供了丰富的机会，将照顾者参与干预与儿童和家庭的结果联系起来。这种以家庭为中心的早期干预策略的净效应是显著降低早发性问题行为的风险，提高学校能力，减少儿童的心理健康障碍，并降低2至10岁的药物使用风险。多变量数据分析的进步，如一般的增长混合建模，将被用来研究与健康和高风险的发展轨迹的形成相关的环境因素，以及确定在改变这些轨迹的家庭干预的有效性。

DESCRIPTION (provided by applicant): The revised application proposes a five-year extension of the Early Steps Multisite Project (ES-M) focused on Understanding and Preventing Early Drug Use Risk. The ES- M project is a collaboration of the Child and Family Center at the University of Oregon (Dishion), the University of Pittsburgh (Shaw), and the University of Virginia (Wilson). The first five years have been quite successful in exceeding expected recruitment rates (731), maintaining high retention rates (85%), engaging families in our family- intervention model, and producing a reduction in problem behavior and emotion distress in children from ages 2 through 4. We have found that improvements in children's adjustment were mediated by improved family management practices. In the next five years we propose to adapt the family intervention model to provide support for each child's transition into the public school system, and conduct developmental analyses to better understand early emergence of school competence, early deviant peer involvement problem behavior, and emotion distress as well as address the role of siblings in development and as an intervention outcome variable. Biannual intensive assessments are proposed that include home visits and direct observations, as well as yearly assessments of the child's problem behavior and self-regulation in the families' context. This assessment builds on an existing multiagent and multimethod assessment strategy across all three sites that have included yearly direct observations as well as measurement of child and family characteristics. We propose that the study will test the effectiveness of a feasible, cost-effective, family-centered intervention that can be initiated within WIC or similar service settings and be continued and maintained in the public school environment. In addition, the data set affords a rich opportunity to link caregiver engagement in the intervention with child and family outcomes. The net effect of this family-centered, early intervention strategy is significant reduction of risk for early- onset problem behavior, improved school competence, reduction in children's mental health disorders, and reductions in risk for drug use risk from age 2 through 10. Advancements in multivariate data analysis such as general growth mixture modeling will be used to study the environmental factors associated with the formation of health and of high-risk developmental trajectories, as well as to determine the effectiveness of the family intervention in altering those trajectories.